Assessment of Pre-Operative Functional Differences in Patients Undergoing Total and Partial Knee Arthroplasties

Abstract

Abstract Background: Osteoarthritis (OA) is a prevalent joint disease causing significant disability, particularly in the knee often treated end-stage with joint replacement surgery. While partial knee arthroplasty (PKA) is noted for quicker recovery and better functionality compared to total knee arthroplasty (TKA), its underutilization highlights a gap in surgical decision-making, driven by a lack of objective data on pre-operative functional differences. Methods: This prospective observational study, conducted from November 2023 to April 2024 at St. Joseph’s Healthcare Hamilton, included 34 end-stage OA patients scheduled for knee arthroplasty. Participants underwent pre-operative functional assessments using markerless motion capture technology to analyze gait and mobility during walking and sit-to-stand tests. Results: The study found no significant differences in basic gait and sit-to-stand metrics between the PKA and TKA groups at a preferred pace. However, at a faster pace, PKA patients demonstrated greater adaptability, showing significant increases in peak stance knee flexion, knee flexion excursions, and stride length, compared to TKA patients whose gait patterns remained consistent across speeds. Conclusion: PKA patients exhibit greater functional adaptability in their pre-operative state, suggesting potential underestimation of their capabilities in current surgical evaluations. Incorporating varied-pace walking tests in pre-operative assessments may provide deeper insights into functional capabilities, influencing more tailored surgical decisions and potentially increasing the application of PKA in suitable candidates.